Provider Demographics
NPI:1720474257
Name:PARAYNO, NELLY (DMD)
Entity Type:Individual
Prefix:DR
First Name:NELLY
Middle Name:
Last Name:PARAYNO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 W MERCED AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-3402
Mailing Address - Country:US
Mailing Address - Phone:626-480-1598
Mailing Address - Fax:626-480-1509
Practice Address - Street 1:1433 W MERCED AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-3402
Practice Address - Country:US
Practice Address - Phone:626-480-1598
Practice Address - Fax:626-480-1509
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2016-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice